First Edition: October 26, 2018

Kaiser Health News: Gun Store Owner Marshals Voters To Expand Medicaid In Idaho
Standing outside the gun shop she co-owns, next to her SUV sporting “NRA” on the license plate, Christy Perry pledges full support for President Donald Trump. “He’s doing a good job,” said Perry, a four-term Republican member of the Idaho legislature who has voted for a litany of conservative causes, including weakening labor unions, restricting abortion and boosting charter schools. With those credentials, Perry hopes for another big win on Election Day — one that puts her at odds with Trump and GOP orthodoxy. She’s helping lead the drive to persuade state voters to expand Medicaid — a central tenet of the Affordable Care Act, the 2010 law embraced by Democrats and derided by many Republicans. (Galewitz, 10/26)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Trump, GOP Fight Back On Health Care
With Election Day less than two weeks away, the Trump administration tried to pivot away from Democrats’ attacks that they are out to dismantle health insurance protections for people with preexisting conditions. The administration made three health care moves over the course of the week, including addressing high prices paid by the Medicare program for drugs administered in doctors’ offices and outpatient facilities. (10/25)

The New York Times: Trump Proposes To Lower Drug Prices By Basing Them On Other Countries’ Costs
President Trump proposed on Thursday that Medicare pay for certain prescription drugs based on the prices paid in other advanced industrial countries — a huge change that could save money for the government and for millions of Medicare beneficiaries. As part of a demonstration project covering half the country, Medicare would establish an “international pricing index” and use it as a benchmark in deciding how much to pay for drugs covered by Part B of Medicare. (Pear, 10/25)

The Associated Press: Trump Says Goal Of Proposal Is To Lower Some US Drug Prices
"We are taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country," Trump said in a speech Thursday at the Department of Health and Human Services. "Same company. Same box. Same pill. Made in the exact same location, and you would go to some countries and it would be 20 percent of the cost of what we pay," said Trump, who predicted the plan will save Americans billions. "We're fixing it." (Alonso-Zaldivar and Riechmann, 10/26)

The Wall Street Journal: Trump Offers Test Plan To Lower Medicare Drug Costs
The proposal wouldn’t likely go into effect until late 2019 or 2020 and would cover only some drugs in Medicare in parts of the country. Some Democrats said the idea would do little in the short term and fall short of Mr. Trump’s more aggressive campaign promise on drug prices. Under the proposal, the Centers for Medicare and Medicaid Services would issue a proposed rule this spring to change how it pays for infused and injected drugs administered by physicians in half of the country. The changes would only apply to some drugs in Medicare’s outpatient program known as Part B, and not the most commonly used medicines sold at pharmacies. (Armour and Walker, 10/25)

NPR: Trump Says Medicare Part B Should Pay Less For Drugs
The proposed changes are related to the Medicare Part B program that pays for medications that patients receive in hospitals or in doctor's offices. Today, Medicare reimburses doctors and hospitals the average sales prices of the drugs, plus 6 percent to cover the cost of giving medications to patients. The arrangement gives physicians an incentive to prescribe the most expensive medications, because they will collect a higher fee, Trump said. (Kodjak, 10/25)

The Washington Post: Trump Says He’s Taking ‘Revolutionary’ Action To Lower Drug Prices
Trump’s remarks were the first as president at HHS and come at a time when health care is playing a defining role in midterm campaigns, with Democrats slamming Republicans over whether they support protecting access to health care for people with preexisting conditions. Trump argued that other countries were being “very disrespectful” by selling their prescription drugs to Americans for higher prices than their citizens are paying for them. (Winfield Cunningham and Sonmez, 10/25)

Stat: Railing Against ‘Global Freeloading,’ Trump Offers Plan To Lower Drug Prices 
Trump’s speech came as his administration has made its work on drug pricing a priority — and as that work, too, has increasingly taken direct aim at pharmaceutical companies. Last week, top officials unveiled a new proposal that would require drug makers to include the prices of their products in TV commercials. The timing, just two weeks before the midterm elections, also bolsters the administration’s argument that it is acting aggressively to curb soaring drug prices, even as Democrats around the country have made health care costs and perceived greed within the pharmaceutical industry central to their campaigns. (Swetlitz, 10/25)

Politico: Trump's Drug Plan Falls Flat In Health Care Messaging War
President Donald Trump tried Thursday to make good on a campaign vow to lower drug prices — attacking “foreign freeloaders” and proposing significant changes to how Medicare pays for many drugs. But his populist proposal didn’t appear likely to budge the national debate around health care, just days ahead of the midterm elections. Early indications are that it won’t be an immediate game changer — it’s too wonky for Republicans playing defense in local races, it gave Democrats a fresh opportunity to slam the administration‘s attacks on patient protections and it won’t help most voters pay less for prescriptions at local pharmacies. (Diamond, 10/25)

Bloomberg: Drug Lobby Compares Trump Drug Price Plan To ‘Socialized’ System 
The lobbying groups for U.S. drugmakers aren’t happy about President Donald Trump’s plan to borrow from Europe’s system of paying for some high-cost drugs. On Thursday, Trump proposed cutting what Medicare pays for many costly drugs that are administered in hospitals and clinics, using a new index of prices that would bring U.S. government payments closer to what European countries pay. (Edney, 10/25)

Stat: Trump’s New Drug Pricing Proposals Have Already Sparked A War With Pharma 
The Trump administration’s new plan to pay for certain drugs in Medicare based on international prices quickly set off a war with the drug industry after it was unveiled Thursday — and both sides are charging ahead with aggressive statements that the other is ignoring patients. The trade group for drug makers, PhRMA, called the proposal “price controls” and said it was “disappointed the administration put the needs of patients aside with these proposals.” (Florko, 10/25)

Stat: These Companies Have The Most To Lose Under New Trump Drug Pricing Plan
President Trump’s forthcoming proposal to lower the cost of expensive physician-administered drugs will hit three drug companies — Amgen, Genentech, and Regeneron — harder than anyone else. Trump is expected to roll out a pilot program Thursday that would tie reimbursement for certain expensive drugs to the prices paid in other similar countries, POLITICO reports. And the Department of Health and Human Services is already out with a report that names the specific drug companies that charge more for their medicines in the U.S. than in other countries. (Florko, 10/25)

Stat: Claire McCaskill's Boldest Claims About Pharma, Annotated 
What does it sound like when a political candidate makes bashing “Big Pharma” a cornerstone of her campaign? Look no further than one of Claire McCaskill’s campaign rallies. On the trail in Missouri, the imperiled Democratic senator is talking about perceived greed within the pharmaceutical industry with an intensity largely unseen in Washington and within other political campaigns. At a recent campaign stop at a Democratic Party office here, McCaskill spent roughly half of a 15-minute stump speech ripping into drug makers and the industry at large. (Facher, 10/25)

The Associated Press: Gillibrand Says In Debate: I'd Finish Out My Senate Term
U.S. Sen. Kirsten Gillibrand of New York and Republican challenger Chele (shehl) Farley have sparred in a televised debate over immigration, health care and whether the incumbent Democrat plans to run for her party's presidential nomination in two years. ... On health care, Gillibrand said she supports Medicare for all, while Farley opposes it as being too costly for taxpayers. (10/25)

The Wall Street Journal: Gillibrand And Farley Spar Over Health Care In Senate Debate
Their 30-minute exchange was cordial, as both women outlined competing proposals on various subjects. Sen. Gillibrand said she would favor a “Medicare for All” plan that would guarantee people have “access to life-saving care.” Ms. Farley questioned the cost of such a measure, and said a single-payer health insurance system might lead to long waits for specialists or surgical procedures. (Vielkind, 10/25)

The Associated Press: AP-NORC Poll: Most Americans See A Sharply Divided Nation
With just two weeks to go until the critical midterm elections, an overwhelming majority of Americans say the United States is greatly divided, according to an Associated Press-NORC Center for Public Affairs Research poll. Few Americans believe those stark divisions will get better anytime soon. ... Overall, top issues for Americans include health care, education, economic growth, Social Security and crime, each of which was called very important by at least three-quarters of Americans. (Summers, 10/25)

The New York Times: Altria To Stop Selling Some E-Cigarette Brands That Appeal To Youths
Under pressure to curb vaping among young people, the tobacco giant Altria announced on Thursday that it would discontinue most of its flavored e-cigarettes and stop selling some brands altogether. The company also said, for the first time, that it would support federal legislation to raise the age to 21 for the purchase of any tobacco and vaping product. (Kaplan, 10/25)

The Washington Post: Marlboro Maker Altria To Halt Sales Of Flavored E-Cigarettes Amid Concerns About Youth-Vaping Surge
The tobacco manufacturer, which also makes Marlboro cigarettes, said it would not put the vaping products back on the market until they get federal clearance or “the youth issue is otherwise addressed.” That means a halt in sales of MarkTen Elite and MarkTen pod-based products. Those pods are essentially cartridges that hold liquids that are turned into vapor before being inhaled. Such pods have become increasingly popular because of their portability and ease of use. The vaping products currently do not need a Food and Drug Administration sign-off if they were on the market before August 2016. (McGinley, 10/25)

The Wall Street Journal: Altria Will Pull Its E-Cigarette Pods From The Market
Altria’s e-cigarettes, sold under the MarkTen and Green Smoke brands, are just a small slice of the U.S. market. Juul is the dominant player, with devices resembling USB sticks and pods in mango, cucumber and other flavors. In a letter to the FDA, Altria Chief Executive Howard Willard said underage use of e-cigarettes is “compounded by flavors that go beyond” traditional tobacco and menthol flavors. (Maloney, 10/25)

The Washington Post: California Blasts Trump Proposal To Freeze Fuel-Efficiency Standards As ‘Nihilistic’ And ‘Illegal’
California officials on Friday plan to submit a 400-page repudiation of the Trump administration’s proposal to freeze fuel-efficiency standards for the nation’s cars and trucks through 2026, calling it a deeply flawed, disingenuous effort that will harm the health and pocketbooks of Americans. “Finalizing this proposal would worsen air quality for the most vulnerable, waste billions of gallons of gasoline, forfeit our best chance to fight climate change, and result in years of uncertainty in the marketplace,” reads a draft of comments from the California Air Resources Board obtained by The Washington Post. It calls the Trump administration’s plan “a contrived solution to justify a predetermined outcome.” (Bennis and Laris, 10/26)

The New York Times: Caitlyn Jenner, A Longtime Republican, Revokes Support For Trump Over Transgender Rights
Caitlyn Jenner, the transgender rights activist who has long drawn criticism from members of the L.G.B.T.Q. community for her Republican leanings, unambiguously denounced President Trump on Thursday for his stance on transgender issues. In a column published in The Washington Post, Ms. Jenner, 68, wrote that she had hoped she could work within the Republican Party to improve its position on L.G.B.T.Q. issues, but that she had evolved to see that belief as a mistake. (Jacobs, 10/25)

Politico: Caitlyn Jenner: 'I Was Wrong' About Trump
“Sadly, I was wrong,” Jenner wrote. “The reality is that the trans community is being relentlessly attacked by this president. ”The New York Times reported Sunday that the Department of Health and Human Services was leading an effort to establish a legal definition of gender under Title IX, the federal civil rights law. The law states that no person can be discriminated against from participating in or receiving benefits of any education program on the basis of gender. (Morin, 10/25)

The Wall Street Journal: Trump’s DEA Chief Vetted Candidates And Then Took The Job Himself, Riling Police Groups
As one of President Trump’s top compliance and ethics attorneys in the White House, Uttam Dhillon had urged several candidates for Drug Enforcement Administration chief to withdraw from consideration, citing concerns about their background checks. Then, he accepted the job himself. Mr. Dhillon’s rise to the top of the world’s largest drug-fighting agency—after being closely involved in the selection process—has riled police groups that had pushed the White House to choose a DEA administrator with a law-enforcement background. (Bender, 10/25)

The Washington Post: FDA Set To Approve Potent Opioid For Market Despite Adviser’s Objections
The Food and Drug Administration is poised to approve a new form of a powerful opioid for use in hospitals and emergency rooms despite opposition from the head of the committee that reviewed the drug. The FDA is scheduled to decide by Nov. 3 whether to allow a California company to produce a 30-microgram pill form of sufentanil, a potent painkiller commonly used after surgery. An FDA advisory committee recommended approval of the drug in a 10-to-3 vote on Oct. 12. The FDA usually follows the guidance of those committees, which are comprised of experts on various drugs and medical devices. (Bernstein, 10/25)

NPR: Meth Is Back. It's Stronger, Purer And Snaring Another Rural Generation
The sharp rise in opioid abuse and fatal overdoses has overshadowed another mounting drug problem: Methamphetamine use is rising across the United States. "Usage of methamphetamine nationally is at an all-time high," says Erik Smith, assistant special agent in charge of the Drug Enforcement Administration's Kansas City office. "It is back with a vengeance." he says. "And the reasons for that are twofold." The drug's now stronger, and cheaper, than it used to be. (Morris, 10/25)

USA Today: Dementia And Alzheimer’s Leave Families Grappling With Elder Guardianship
Casey Kasem’s widow battled his children to maintain medical control of the radio legend as he faded with a form of dementia. The wife and daughter of actor and comedian Tim Conway are sparring in court over the care of the former Carol Burnett Show star. Similar disputes divided the families of country music icon Glen Campbell and R&B singer Etta James. Star Trek actress Nichelle Nichols is the subject of a court action brought by her son. The high-profile legal battles around celebrities incapacitated by dementia are drawing attention to a phenomenon dividing many more families across the country. (Alltucker, 10/25)

The Washington Post: Drop In Adult Flu Vaccinations May Be Factor In Last Season’s Record-Breaking Deaths, Illnesses
Fewer than 4 out of 10 adults in the United States got flu shots last winter, the lowest rate in seven seasons and one likely reason that the 2017-2018 season was the deadliest in decades. Reports released Thursday by the Centers for Disease Control and Prevention provide new details outlining the severity of the past flu season, during which more people were killed by seasonal influenza than in any other since the 1970s. (Sun, 10/25)

NPR: Cerebellum Plays Bigger Role In Human Thought Than Previously Suspected
An ancient part of the brain long ignored by the scientific world appears to play a critical role in everything from language and emotions to daily planning. It's the cerebellum, which is found in fish and lizards as well as people. But in the human brain, this structure is wired to areas involved in higher-order thinking, a team led by researchers from Washington University in St. Louis reports Thursday in the journal Neuron. (Hamilton, 10/25)

Bloomberg: How Much Herbicide Can You Tolerate In Your Food? 
By now, many consumers have heard of glyphosate, the active ingredient in the herbicide known as Roundup, and warnings about its presence in many of their favorite foods. From oatmeal to granola bars, ice cream to even orange juice, trace amounts of the chemical can be found throughout your local supermarket. It’s the world’s most widely used weedkiller—a blockbuster for Monsanto Co. since it was introduced in the 1970s. The vast majority of U.S. corn and soybeans have been genetically modified to withstand it, making it a critical component of modern farming. But in 2015, the International Agency for Research on Cancer—an arm of the World Health Organization—labeled it a probable carcinogen. Since then, it’s become a legal headache for Monsanto, and now Bayer AG, which bought the company in June for $66 billion. (Shanker and Mulvany, 10/26)

Stat: A History Of Science And Biotech, Told Through Words Added To The Dictionary
How old were you when CRISPR got added to the dictionary? And what were your grandparents doing when DNA made its first appearance?Now you can find out. Merriam-Webster has been promoting a search tool that lets you look up the words that got added to dictionary in the year you were born, or any other year dating all the way back to 1500. ...We at STAT decided to scour Merriam-Webster’s trove for some of the most important words that have shaped science in the past century. Taken a whole, the list is a revealing lens through which to understand the history of science and biotech. (Robbins, 10/26)

The New York Times: Breast-Feeding Is Good For The Mother, And Not Just The Baby
Most women know breast-feeding is good for their babies’ health. But doctors and midwives rarely tell moms-to-be that it’s also good for nursing mothers. Nursing mothers reduce their relative risk of breast cancer by 4.3 percent for every 12 months they breast-feed, in addition to a relative decrease of 7 percent for each birth. Breast-feeding is particularly protective against some of the most aggressive tumors, called hormone receptor-negative or triple-negative tumors, which are more common among African-American women, studies show. It also lowers the risk by one-third for women who are prone to cancer because of an inherited BRCA1 mutation. (Rabin, 10/26)

The Wall Street Journal: When It Comes To Sleep, One Size Fits All
I’d always thought that our need for sleep, like our appetite for food, drink or social contact, was a personal matter: Some people need more, some need less. Age, lifestyle, work and metabolism combine to determine how much sleep a person needs to function, and if some people thrive on five hours a night and others require seven, chalk it up to different strokes for different folks, right? Wrong. A new study of the sleep habits of more than 10,000 people around the world suggests that the amount of sleep adults need is universal. The massive survey, published in the journal Sleep, demonstrates that adults everywhere need 7-8 hours a night—no more and no less—in order to be mentally limber. (Pinker, 10/25)

The Associated Press: 19th Case Confirmed In Viral Outbreak That Killed 7
New Jersey health officials said Thursday tests confirmed a 19th patient has been infected in a viral outbreak at a pediatric rehabilitation center that has killed seven people. The unidentified person had already been ill so the diagnosis does not necessarily mean the virus is still spreading, according to Health Department spokeswoman Donna Leusner. (10/25)

The Wall Street Journal: Advocates Push For Better Mental-Health Care For Asian New Yorkers
The case last month of an allegedly mentally-ill Asian woman charged with stabbing several people has highlighted what advocates say is a troubling insufficiency in mental health care services for New York City’s growing Asian population. The system is hampered by a shortage of culturally fluent providers, wait times that can stretch to weeks and a lack of adequate governmental funding, the advocates say. (West, 10/25)

The Associated Press: Task Force Preparing To Investigate Detroit Funeral Home
A police task force is preparing to investigate a Detroit funeral home where 36 fetuses were found in boxes and 27 others in freezers, the city's police chief said Thursday. Chief James Craig told reporters at a news conference that the task force will include his officers, state police and the FBI. On Monday, the task force will start looking into operations at the Perry Funeral Home , where the fetuses were found last week. (10/25)